DEB-TACE序贯射频消融治疗原发性肝癌患者效果研究  

Sequential drug-eluting beads-transcatheter arterial chemoembolization and radiofrequency ablation in the treatment of patients with primary liver cancer

作　　者：陈长广[1] 肖荣 王俊[1] Chen Changguang;Xiao Rong;Wang Jun(Department of Oncology,First People's Hospital,Affiliated to Jiangsu University,Kunshan 215300,Jiangsu Province,China)

机构地区：[1]江苏大学附属昆山第一人民医院肿瘤内科,江苏省昆山市215300

出　　处：《实用肝脏病杂志》2023年第5期706-709,共4页Journal of Practical Hepatology

基　　金：江苏省科技厅科研基金资助项目(编号:QNRC2021314)。

摘　　要：目的 探讨采用药物洗脱微球肝动脉化疗栓塞(DEB-TACE)序贯射频消融(RFA)治疗原发性肝癌(PLC)患者的疗效。方法 2017年11月~2020年11月我院诊治的PLC患者72例,其中接受DEB-TACE治疗38例作为对照组,接受DEB-TACE序贯RFA治疗34例为观察组。采用电化学发光法检测血清甲胎蛋白(AFP)、热休克蛋白90α(HSP90α)、糖类抗原125(CA125)和CA199水平。术后行影像学检查,评估疗效。结果 治疗后近期随访,观察组和对照组客观缓解率分别为79.4%和55.3%,差异有统计学意义(P<0.05);观察组血清AFP、HSP90α和CA125水平分别为(123.6±32.5)μg/L、(97.6±21.6)ng/mL和(30.2±13.2)U/mL,均显著低于对照组【分别为(264.5±34.6)μg/L、(129.1±22.3)ng/mL和(71.6±14.3)U/mL,P<0.05】;观察组患者中位总体生存(OS)为28个月,其1 a和2 a生存率分别为88.2%和67.6%,而对照组患者中位OS为20个月,其1 a和2 a生存率分别为71.1%和42.1%,两组差异显著(Log Rank x2=4.258,P=0.039)。结论 采用DEB-TACE序贯RFA治疗PLC患者临床疗效确切,可显著延长患者生存时间。Objective The aim of this study was to observe the efficacy of sequential drug-eluting beads-transcatheter arterial chemoembolization(DEB-TACE)and radiofrequency ablation(RFA)in the treatment of patients with primary liver cancer(PLC).Methods 72 patients with PLC were admitted to our hospital between November 2017 and November 2020,and among them,the DEB-TACE were done in 38 cases as the control,and the sequential DEB-TACE and RFA were carried out in other 34 cases as the observation group.Serum alpha-fetoprotein(AFP),heat shock protein 90α(HSP90α),carbohydrate antigen 125(CA125)and CA199 levels were detected by electrochemiluminescence.The post-operational efficacy was evaluated by imaging.Results At the end of three month after operation,the objective remission rate in the observation and control group were 79.4%and 55.3%,significantly different(P<0.05);serum AFP,HSP90αand CA125 levels in the observation group were(123.6±32.5)μg/L,(97.6±21.6)ng/mL and(30.2±13.2)U/mL,all significantly lower than[(264.5±34.6)μg/L,(129.1±22.3)ng/mL and(71.6±14.3)U/mL,respectively,P<0.05]in the control group;the mean overall survival(OS)in the observation group was 28 months,with one-year and two-year survival of 88.2%and 67.6%,while the OS in the control was 20 months,with the one-year and two-year survival of71.1%and 42.1%,significantly different between the two groups(Log Rank x 2=4.258,P=0.039).Conclusion The sequential DEB-TACE and RFA in the treatment of patients with PLC has a definite clinical efficacy,which might prolong the survival of patients.

关 键 词：原发性肝癌 药物洗脱微球 肝动脉化疗栓塞 射频消融 治疗 总体生存率 

分 类 号：R735.7[医药卫生—肿瘤]